Ultrasound diagnosis has been used for abdominal aortic aneurysms and peripheral aneurysms for many years, yet the nuances required for proper interrogation and interpretation can be quite difficult. While CT and ultrasound have been used interchangeably, it is become clear that the measurements derived are not necessarily equivalent. Newer ultrasound technology allows CT and ultrasound images to be fused for correlation of differences between these modalities. This fusion technology may allow differences between the imaging techniques to be resolved during the real-time ultrasound evaluation.
Major trials such as the UK Small Aneurysm Trial utilized ultrasound as the primary modality for imaging abdominal aortic aneurysms that did not yet require intervention. Once an aneurysm reaches the size appropriate for intervention, then CT scans provide an objective data set that can be used in a number of ways for procedure planning. The complementary use of CT and ultrasound for the management of abdominal aortic aneurysms is critical to the proper management of these patients. By using ultrasound, radiation and intravenous contrast can be avoided until such time as intervention planning becomes necessary.
In the periphery ultrasound has always had a preeminent role in the diagnosis and management of extremity aneurysms in particular. Both femoral and popliteal aneurysms can be followed and management planned based on ultrasound alone. While ultrasound in the abdomen may be limited by bowel gas and patient body habitus, in the periphery these issues are rarely a concern. Overall, ultrasound and CT imaging are complementary modalities that allow both deep imaging and noninvasive surveillance depending on the clinical scenario.
- Ultrasound diagnosis of aneurysms
- Abdominal aortic aneurysm
- Popliteal aneurysms
- CT scans for AAA diagnosis
- Femoral aneurysms
- CT versus ultrasound for AAA diagnosis
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When measuring the AAA size:
B-mode ultrasound is within 1 cm of the true aortic diameter in 75% of patients.
B-mode ultrasound is within 0.5 cm of the true aortic diameter in 75% of patients.
B-mode ultrasound is within 0.2 cm of the true aortic diameter in 75% of patients.
B-mode ultrasound is within 0.5 cm of the true aortic diameter in 100% of patients.
When planning EVAR:
CT scanning is the primary method for endograft sizing and determining aortic neck anatomy.
Duplex ultrasound is the primary method for endograft sizing and determining aortic neck anatomy.
Both CT scanning and duplex ultrasound are equally effective in endovascular sizing and determining aortic neck anatomy.
All of the above.
When comparing the accuracy of CT scanning and duplex ultrasound measurements in determining the size of AAA:
CT scan measurements are usually larger than ultrasound imaging measurements.
CT scan measurements are usually smaller than ultrasound imaging measurements.
CT scan measurements and ultrasound imaging measurements are equivalent.
None of the above.
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Stickley, S.M., Meier, G.H. (2017). The Role of Color Duplex Ultrasound in Patients with Abdominal Aortic Aneurysms and Peripheral Aneurysms. In: AbuRahma, A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-319-54760-2_53
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-54758-9
Online ISBN: 978-3-319-54760-2